Described herein are methods and apparatus for detecting stones by ultrasound, in which the ultrasound reflections from a stone are preferentially selected and accentuated relative to the ultrasound reflections from blood or tissue. Also described herein are methods and apparatus for applying pushing ultrasound to in vivo stones or other objects, to facilitate the removal of such in vivo objects.
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1. A non-lithotriptic method for applying an in vivo rotational force to a stone in a body, the non-lithotriptic method comprising rotating the stone in vivo, without fragmenting the stone, by applying ultrasound having an I SPTA of at least 3 W/cm 2 .
A method uses ultrasound to rotate a kidney stone or similar object inside the body without breaking it apart. This is achieved by applying ultrasound with a specific intensity (ISPTA) of at least 3 Watts per square centimeter. The ultrasound provides a rotational force to the stone, enabling its movement within the body. The method is non-lithotriptic, meaning it doesn't fragment the stone during this rotation process.
2. The non-lithotriptic method of claim 1 wherein the ultrasound has I SPTA of at least 4 W/cm 2 .
This method for rotating stones in the body using ultrasound, builds upon the previous description by specifying a higher ultrasound intensity. Specifically, the ultrasound used to rotate the stone has an intensity (ISPTA) of at least 4 Watts per square centimeter, to increase the rotational force imparted on the in vivo stone.
3. The non-lithotriptic method of claim 1 wherein the ultrasound has a pressure amplitude in the range of about 5 MPa to about 30 MPa.
This method rotates stones within the body using ultrasound. The key is controlling the ultrasound's pressure amplitude, which should be in the range of about 5 MegaPascals (MPa) to about 30 MPa. This controlled pressure, alongside a I SPTA of at least 3 W/cm 2 (from claim 1) generates the necessary rotational force without fragmenting the stone.
4. The non-lithotriptic method of claim 3 wherein the ultrasound has a pressure amplitude in the range of about 10 MPa to about 20 MPa.
Building upon the method that rotates kidney stones using ultrasound with a pressure amplitude between 5 MPa and 30 MPa, this variation narrows the pressure range. Here, the ultrasound pressure amplitude is more specifically controlled to be between about 10 MPa and about 20 MPa, while using ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1).
5. The non-lithotriptic method of claim 4 wherein the ultrasound has a pressure amplitude in the range of about 13 MPa to about 18 MPa.
This method further refines the ultrasound pressure amplitude used to rotate kidney stones. Instead of a range of 10-20 MPa, the pressure amplitude is now specified to be between about 13 MPa and about 18 MPa, alongside a I SPTA of at least 3 W/cm 2 (from claim 1). This fine-tuning optimizes the rotational force applied to the stone.
6. The non-lithotriptic method of claim 1 wherein a frequency of the ultrasound is in the range of about 0.25-5 MHz.
The method rotates kidney stones or similar objects using ultrasound with a frequency in the range of approximately 0.25 to 5 MHz, while using ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1). This frequency range influences the way the ultrasound interacts with the stone, affecting the efficiency of the rotation.
7. The non-lithotriptic method of claim 6 wherein said frequency of the ultrasound is in the range of about 1-4 MHz.
The ultrasound-based stone rotation method uses a more specific ultrasound frequency range. Instead of 0.25-5 MHz, the frequency is narrowed to between about 1 MHz and 4 MHz, alongside a I SPTA of at least 3 W/cm 2 (from claim 1), to improve rotational force on the in vivo stones.
8. The non-lithotriptic method of claim 7 wherein said frequency of the ultrasound is in the range of about 1-3 MHz.
This method further refines the ultrasound frequency for rotating stones. Instead of 1-4 MHz, the frequency is now specified to be between about 1 MHz and 3 MHz, while using ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1).
9. The non-lithotriptic method of claim 1 wherein a duty cycle of the ultrasound pulses is greater than 1% over a period of about 1 second.
The ultrasound used to rotate kidney stones inside the body is pulsed, rather than continuous. The method defines that the duty cycle (the percentage of time the ultrasound is actively transmitting) is greater than 1% over a 1-second period, while using ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1).
10. The non-lithotriptic method of claim 1 wherein a spatial peak pulse average intensity of the ultrasound is greater than 190 W/cm 2 .
This method rotates kidney stones using pulsed ultrasound, and specifies the spatial peak pulse average intensity (ISPTA) of the ultrasound. The ISPTA must be greater than 190 W/cm², and the I SPTA of at least 3 W/cm 2 (from claim 1).
11. The non-lithotriptic method of claim 1 wherein the spatial peak time average intensity of the ultrasound is greater than 720 W/cm 2 .
The method rotates kidney stones using pulsed ultrasound, specifying that the spatial peak time average intensity (ISPTA) of the ultrasound is greater than 720 W/cm², while using ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1).
12. The non-lithotriptic method of claim 1 wherein an intensity and duration of the ultrasound does not cause thermal coagulation of tissue.
When rotating stones in the body using ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1), the intensity and duration of the ultrasound pulses are carefully controlled. This ensures that the ultrasound doesn't cause thermal coagulation (heating and damage) of surrounding tissues.
13. The non-lithotriptic method of claim 1 wherein said rotational force is applied to urge said stone toward an exit location.
After applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1) to rotate a stone inside the body, the method uses this rotational force to move the stone towards an exit location. This is done without fragmenting the stone.
14. The non-lithotriptic method of claim 13 wherein one or more stones are located in a kidney, and said exit location is an exit from the kidney.
For stones located in a kidney, the method described above that rotates stones using ultrasound having an I SPTA of at least 3 W/cm 2 and then urges the stone toward an exit location, specifically targets an exit point from the kidney as the destination for the stone.
15. The non-lithotriptic method of claim 1 wherein said rotational force is applied to urge said stone towards the ureteropelvic junction.
After applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1) to rotate a stone inside the body, the method uses this rotational force to move the stone towards the ureteropelvic junction, where the kidney connects to the ureter.
16. The non-lithotriptic method of claim 1 wherein said rotational force is applied to urge said stone within the ureter.
The method rotates kidney stones within the ureter using ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1) and then uses this rotational force to move the stone along the ureter.
17. The non-lithotriptic method of claim 1 comprising the further step of fragmenting the stone by lithotripsy after rotating the stone.
Subsequent to rotating the stone in vivo without fragmenting it, by applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1), the method then proceeds to fragment the stone using lithotripsy, after this rotation process has been completed.
18. The non-lithotriptic method of claim 1 comprising the further step of detecting said stone before an application of the rotational force.
Before rotating the stone in vivo without fragmenting it, by applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1), the method first locates or detects the stone within the body using a suitable detection method.
19. The non-lithotriptic method of claim 18 further comprising detecting said stone through imaging.
Before rotating the stone in vivo without fragmenting it, by applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1), the method first detects the stone through some form of imaging technology.
20. The non-lithotriptic method of claim 19 wherein the imaging comprises real-time imaging.
Before rotating the stone in vivo without fragmenting it, by applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1), the method first detects the stone through imaging and this imaging is performed in real-time, allowing for immediate visualization and guidance.
21. The non-lithotriptic method of claim 19 wherein said imaging is accomplished with Doppler ultrasound or B-mode wherein a frequency of said imaging ultrasound is in the range of about 1-5 MHz.
Before applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1) to rotate the stone, the method uses Doppler ultrasound or B-mode ultrasound imaging to detect the stone. The imaging ultrasound frequency is in the range of about 1-5 MHz.
22. The non-lithotriptic method of claim 21 wherein said frequency of said imaging ultrasound is in the range of about 2-4 MHz.
The stone detection imaging (before applying ultrasound having an I SPTA of at least 3 W/cm 2 to rotate the stone) uses Doppler ultrasound or B-mode ultrasound with a frequency in the range of about 2-4 MHz, instead of 1-5 MHz, to improve resolution and accuracy.
23. The non-lithotriptic method of claim 21 wherein said frequency of said imaging ultrasound is in the range of about 2-3 MHz.
The stone detection imaging (before applying ultrasound having an I SPTA of at least 3 W/cm 2 to rotate the stone) uses Doppler ultrasound or B-mode ultrasound with a frequency in the range of about 2-3 MHz, instead of 1-5 MHz, to further refine image quality.
24. The non-lithotriptic method of claim 19 wherein said imaging is accomplished by a method selected from the group consisting of fluoroscopy, computer tomography, low-dose stone protocol computer tomography, B-mode ultrasound, Doppler ultrasound, and MRI.
Before applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1) to rotate the stone, the method detects the stone using one of several imaging methods: fluoroscopy, computer tomography, low-dose stone protocol computer tomography, B-mode ultrasound, Doppler ultrasound, or MRI.
25. The non-lithotriptic method of claim 24 wherein said imaging is accomplished with Doppler ultrasound.
Before applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1) to rotate the stone, the method uses Doppler ultrasound to locate the stone using imaging.
26. The non-lithotriptic method of claim 25 wherein locating the stone comprises use of a twinkling artifact of Doppler ultrasound.
When using Doppler ultrasound to locate the stone before rotating it with ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1), the method identifies the stone based on the "twinkling artifact," a visual phenomenon in Doppler imaging that helps highlight small, reflective objects like stones.
27. The non-lithotriptic method of claim 24 wherein said imaging is accomplished with B-mode ultrasound.
Before applying ultrasound having an I SPTA of at least 3 W/cm 2 (from claim 1) to rotate the stone, the method uses B-mode ultrasound to detect the stone by visualizing it through grayscale anatomical imaging.
Cooperative Patent Classification codes for this invention. Click any code to explore related patents in that topic.
October 30, 2015
March 21, 2017
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